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Ambulatory Health Care Facilities Clinic/Center Community Health

Provider NPI: 1134574346

Organization Information:
Organization is not Subpart
Authorized Official:  AMBROSE  KPOTO  MARKETING & BUSINESS DEVELOPMENT  651-333-4582

Practice Location:
Tel: 651-333-4582  Fax: --

Business Mailing Address:
Tel: 612-203-7055  Fax: 877-758-5066

NPI Information:
NPI: 1134574346
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
N261QC1500XAmbulatory Health Care Facilities
Community Health
Military Hospital
N3104A0630XNursing & Custodial Care Facilities
Assisted Living Facility
N311ZA0620XNursing & Custodial Care Facilities
Custodial Care Facility
N313M00000XNursing & Custodial Care Facilities
Nursing Facility/Intermediate Care Facility
N3140N1450XNursing & Custodial Care Facilities
Skilled Nursing Facility
N323P00000XResidential Treatment Facilities
Psychiatric Residential Treatment Facility
Durable Medical Equipment & Medical Supplies
Durable Medical Equipment & Medical Supplies

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 332B00000X





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